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      A Novel Ferroptosis-Related Gene Signature Predicts Overall Survival of Breast Cancer Patients

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          Abstract

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          Ferroptosis is an iron-dependent cell death which is distinctive from common forms of cell death. Accumulating evidence indicated the close relationship between ferroptosis and numerous human diseases. Regarding breast cancer, a related study indicated that some targeted medicines could induce ferroptosis, furthermore, some basic research found that ferroptosis-related genes were closely related to breast cancer. However, the correlation between ferroptosis-related genes and breast cancer patients’ prognosis remains unknown. We built an 8-ferroptosis-related-gene model to predict breast cancer patients’ prognosis. This model could stratify patients into high- or low-risk groups. Additionally, tumor microenvironment analyses displayed differently enriched immune cells and immune pathways between these two groups. This 8-gene model is believed to be of great value in predicting prognosis for breast cancer patients.

          Abstract

          Breast cancer is the second leading cause of death in women, thus a reliable prognostic model for overall survival (OS) in breast cancer is needed to improve treatment and care. Ferroptosis is an iron-dependent cell death. It is already known that siramesine and lapatinib could induce ferroptosis in breast cancer cells, and some ferroptosis-related genes were closely related with the outcomes of treatments regarding breast cancer. The relationship between these genes and the prognosis of OS remains unclear. The data of gene expression and related clinical information was downloaded from public databases. Based on the TCGA-BRCA cohort, an 8-gene prediction model was established with the least absolute shrinkage and selection operator (LASSO) cox regression, and this model was validated in patients from the METABRIC cohort. Based on the median risk score obtained from the 8-gene model, patients were stratified into high- or low-risk groups. Cox regression analyses identified that the risk score was an independent predictor for OS. The findings from CIBERSORT and ssGSEA presented noticeable differences in enrichment scores for immune cells and pathways between the abovementioned two risk groups. To sum up, this prediction model has potential to be widely applied in future clinical settings.

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          Most cited references35

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          ACSL4 dictates ferroptosis sensitivity by shaping cellular lipid composition.

          Ferroptosis is a form of regulated necrotic cell death controlled by glutathione peroxidase 4 (GPX4). At present, mechanisms that could predict sensitivity and/or resistance and that may be exploited to modulate ferroptosis are needed. We applied two independent approaches-a genome-wide CRISPR-based genetic screen and microarray analysis of ferroptosis-resistant cell lines-to uncover acyl-CoA synthetase long-chain family member 4 (ACSL4) as an essential component for ferroptosis execution. Specifically, Gpx4-Acsl4 double-knockout cells showed marked resistance to ferroptosis. Mechanistically, ACSL4 enriched cellular membranes with long polyunsaturated ω6 fatty acids. Moreover, ACSL4 was preferentially expressed in a panel of basal-like breast cancer cell lines and predicted their sensitivity to ferroptosis. Pharmacological targeting of ACSL4 with thiazolidinediones, a class of antidiabetic compound, ameliorated tissue demise in a mouse model of ferroptosis, suggesting that ACSL4 inhibition is a viable therapeutic approach to preventing ferroptosis-related diseases.
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            Ferroptosis as a p53-mediated activity during tumour suppression.

            Although p53-mediated cell-cycle arrest, senescence and apoptosis serve as critical barriers to cancer development, emerging evidence suggests that the metabolic activities of p53 are also important. Here we show that p53 inhibits cystine uptake and sensitizes cells to ferroptosis, a non-apoptotic form of cell death, by repressing expression of SLC7A11, a key component of the cystine/glutamate antiporter. Notably, p53(3KR), an acetylation-defective mutant that fails to induce cell-cycle arrest, senescence and apoptosis, fully retains the ability to regulate SLC7A11 expression and induce ferroptosis upon reactive oxygen species (ROS)-induced stress. Analysis of mutant mice shows that these non-canonical p53 activities contribute to embryonic development and the lethality associated with loss of Mdm2. Moreover, SLC7A11 is highly expressed in human tumours, and its overexpression inhibits ROS-induced ferroptosis and abrogates p53(3KR)-mediated tumour growth suppression in xenograft models. Our findings uncover a new mode of tumour suppression based on p53 regulation of cystine metabolism, ROS responses and ferroptosis.
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              Targeting Ferroptosis to Iron Out Cancer

              One of the key challenges in cancer research is how to effectively kill cancer cells while leaving the healthy cells intact. Cancer cells often have defects in cell death executioner mechanisms, which is one of the main reasons for therapy resistance. To enable growth, cancer cells exhibit an increased iron demand compared with normal, non-cancer cells. This iron dependency can make cancer cells more vulnerable to iron-catalyzed necrosis, referred to as ferroptosis. The identification of FDA-approved drugs as ferroptosis inducers creates high expectations for the potential of ferroptosis to be a new promising way to kill therapy-resistant cancers.
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                Author and article information

                Contributors
                Role: Academic Editor
                Journal
                Biology (Basel)
                Biology (Basel)
                biology
                Biology
                MDPI
                2079-7737
                14 February 2021
                February 2021
                : 10
                : 2
                : 151
                Affiliations
                [1 ]Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou 510060, Guangdong, China; lihf@ 123456sysucc.org.cn (H.L.); lilu1@ 123456sysucc.org.cn (L.L.); xuecong@ 123456sysucc.org.cn (C.X.); huangrq@ 123456sysucc.org.cn (R.H.); huaq@ 123456sysucc.org.cn (A.H.)
                [2 ]State Key Laboratory of Oncology in South China, Guangzhou 510060 Guangdong, China
                [3 ]Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, Guangdong, China
                Author notes
                [* ]Correspondence: anxin@ 123456sysucc.org.cn (X.A.); shiyx@ 123456sysucc.org.cn (Y.S.); Tel.: +86-20-87343801 (X.A. & Y.S.)
                [†]

                These authors contributed equally to this work.

                Author information
                https://orcid.org/0000-0002-5414-8049
                Article
                biology-10-00151
                10.3390/biology10020151
                7917807
                33672990
                267e9854-433e-4883-a25d-d51d2dec3656
                © 2021 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 29 December 2020
                : 10 February 2021
                Categories
                Article

                breast cancer,ferroptosis,gene signature,prognosis,immune status

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